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Dtsch Med Wochenschr 2001; 126(5): 117-122
DOI: 10.1055/s-2001-10881
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© Georg Thieme Verlag Stuttgart · New York

Lebererkrankungen durch Alkoholkonsum und Hepatitis-C-Virusinfektion: Assoziation, Addition oder Potenzierung?

D. M. Alscher1 , J. Chr Bode2
  • 1Abteilung Innere Medizin IV (Schwerpunkte Allgemeine Innere Medizin und Nephrologie)
  • 2Abteilung Innere Medizin I (Schwerpunkte Gastroenterologie, Hepatologie und Endokrinologie) Zentrum für Innere Medizin, Robert-Bosch-Krankenhaus, Stuttgart
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Publication History

Publication Date:
31 December 2001 (online)

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Chronischer Alkoholabusus ist in Deutschland, ebenso wie in vielen anderen europäischen Ländern, die häufigste Ursache für die Entwicklung chronischer Lebererkrankungen. Eingehende Untersuchungen seit Anfang der 90er-Jahre ergaben, dass die HCV-Infektion an zweiter Stelle der Ursachen für chronische Lebererkrankungen rangiert. In den letzten Jahren mehrten sich Mitteilungen in der Literatur über eine besondere Gefährdung, wenn beide Faktoren, Alkoholkonsum und HCV-Infektion, zusammentreffen. In der nachfolgenden Übersicht sollen die wichtigsten Erkenntnisse zur Assoziation und der gegenseitigen Beeinflussung von chronischem Alkoholkonsum und HCV-Infektion auf die Entstehung und den Verlauf von Lebererkrankungen zusammengefasst werden.

Literatur

  • 1 Batey R G, Burns T, Benson R J, Byth K. Alcohol consumption and the risk of cirrhosis.  Med J Aust. 1992;  156 413-416
    Google Scholar
  • 2 Bode J C, Alscher D M, Wisser H, Bode C. Detection of hepatitis C virus antibodies and hepatitis C virus RNA in patients with alcoholic liver disease.  Alcohol Alcohol. 1995;  30 97-103
    Google Scholar
  • 3 Bode J C, Biermann J, Kohse K P, Walker S, Bode C. High incidence of antibodies to hepatitis C virus in alcoholic cirrhosis: fact or fiction?.  Alcohol Alcohol. 1991;  26 111-114
    Google Scholar
  • 4 Coelho-Little M E, Jeffers L J, Bernstein D E. et al . Hepatitis C virus in alcoholic patients with and without clinically apparent liver disease.  Alcohol Clin Exp Res. 1995;  19 1173-1176
    Google Scholar
  • 5 Corrao G, Arico S. Independent and combined action of hepatitis C virus infection and alcohol consumption on the risk of symptomatic liver cirrhosis.  Hepatology. 1998;  27 914-919
    Google Scholar
  • 6 Corrao G, Arico S, Zambon A. et al . Is alcohol a risk factor for liver cirrhosis in HBsAg and anti-HCV negative subjects? Collaborative Groups for the Study of Liver Diseases in Italy.  J Hepatol. 1997;  27 470-476
    Google Scholar
  • 7 Cromie S L, Jenkins P J, Bowden D S, Dudley F J. Chronic hepatitis C: effect of alcohol on hepatitic activity and viral titer.  J Hepatol. 1996;  25 821-826
    Google Scholar
  • 8 Degos F. Hepatitis C and alcohol.  J Hepatol. 1999;  31 113-118 (Suppl 1)
    Google Scholar
  • 9 Deutsche Hauptstelle für die Suchtgefahren .Jahrbuch Sucht `95. Geeshacht, Neuland 1994
    Google Scholar
  • 10 Donato F, Tagger A, Chiesa R. et al . Hepatitis B and C virus infection, alcohol drinking, and hepatocellular carcinoma: A case-control study in Italy. Brescia HCC Study.  Hepatology. 1997;  26 579-584
    Google Scholar
  • 11 Geissler M, Gesien A, Wands J R. Inhibitory effects of chronic ethanol consumption on cellular immune responses to hepatitis C virus core protein are reversed by genetic immunizations augmented with cytokine-expressing plasmids.  J Immunol. 1997;  159 5107-5113
    Google Scholar
  • 12 Grellier L F, Dusheiko G M. The role of hepatitis C virus in alcoholic liver disease.  Alcohol Alcohol. 1997;  32 103-111
    Google Scholar
  • 13 Ikeda K, Saitoh S, Koida I. et al . A multivariate analysis of risk factors for hepatocellular carcinogenesis: a prospective observation of 795 patients with viral and alcoholic cirrhosis.  Hepatology. 1993;  18 47-53
    Google Scholar
  • 14 Khan M H, Thomas L, Byth K. et al . How much does alcohol contribute to the variability of hepatic fibrosis in chronic hepatitis C?.  J Gastroenterol Hepatol. 1998;  13 419-426
    Google Scholar
  • 15 Laskus T, Radkowski E, Lupa E, Horban A, Cianciara J, Slusarczyk J. Prevalence of markers of hepatitis viruses in out-patient alcoholics.  J Hepatol. 1992;  15 174-178
    Google Scholar
  • 16 Laurent-Puig P, Dussaix E, Lecoz Y, Martes P, Buffet C. Prevalence of anti-hepatitis C virus antibodies among patients with alcoholic liver disease, supplemented by 4-RIBA.  Dig Dis Sci. 1992;  37 156-157
    Google Scholar
  • 17 Leal R J, McHutchison J G, Houghton M, Choo O L, Kuo G, Redeker A G. Antibodies to hepatitis C virus (anti-HCV) in alcoholic liver disease: an analysis of risk factors.  Hepatology. 1990;  12 881
    Google Scholar
  • 18 Lelbach W K. Cirrhosis in the alcoholic and its relation to the volume of alcohol abuse.  Ann N Y Acad Sci. 1975;  252 85-105
    Google Scholar
  • 19 Lieber C S. Medical disorders of alcoholism.  N Engl J Med. 1995;  333 1058-1065
    Google Scholar
  • 20 Mendenhall C L, Seeff L, Diehl A M. et al . Antibodies to hepatitis B virus and hepatitis C virus in alcoholic hepatitis and cirrhosis: their prevalence and clinical relevance. The VA Cooperative Study Group (No. 119).  Hepatology. 1991;  14 581-589
    Google Scholar
  • 21 Miyakawa H, Sato C, Izumi N. et al . Hepatitis C virus infection in alcoholic liver cirrhosis in Japan: its contribution to the development of hepatocellular carcinoma.  Alcohol Alcohol. 1993;  Suppl 1A 85-90
    Google Scholar
  • 22 Mochida S, Ohnishi K, Matsuo S, Kakihara K, Fujiwara K. Effect of alcohol intake on the efficacy of interferon therapy in patients with chronic hepatitis C as evaluated by multivariate logistic regression analysis.  Alcohol Clin Exp Res. 1996;  20 371A-377A
    Google Scholar
  • 23 Nakano M, Maruyama K, Okuyama K. et al . The characteristics of alcoholics with HCV infection: histopathologic comparison with alcoholics without HCV infection and chronic type C hepatitis.  Alcohol Alcohol. 1993;  Suppl 1B 35-40
    Google Scholar
  • 24 Nalpas B, Driss F, Pol S. et al . Association between HCV and HBV infection in hepatocellular carcinoma and alcoholic liver disease.  J Hepatol. 1991;  12 70-74
    Google Scholar
  • 25 Nalpas B, Feitelson M, Brechot C, Rubin E. Alcohol, hepatotropic viruses, and hepatocellular carcinoma.  Alcohol Clin Exp Res. 1995;  19 1089-1095
    Google Scholar
  • 26 Naoumov N V, Chokshi S, Metivier E, Maertens G, Johnson P J, Williams R. Hepatitis C virus infection in the development of hepatocellular carcinoma in cirrhosis.  J Hepatol. 1997;  27 331-336
    Google Scholar
  • 27 Niederau C, Lange S, Heintges T. et al . Prognosis of chronic hepatitis C: Results of a large, prospective cohort study.  Hepatology. 1998;  28 1687-1695
    Google Scholar
  • 28 Nishiguchi S, Kuroki T, Yabusako T. et al . Detection of hepatitis C virus antibodies and hepatitis C virus RNA in patients with alcoholic liver disease.  Hepatology. 1991;  14 985-989
    Google Scholar
  • 29 Noda K, Yoshihara H, Suzuki K. et al . Progression of type C chronic hepatitis to liver cirrhosis and hepatocellular carcinoma-its relationship to alcohol drinking and the age of transfusion.  Alcohol Clin Exp Res. 1996;  20 95A-100A
    Google Scholar
  • 30 Okazaki T, Yoshihara H, Suzuki K. et al . Efficacy of interferon therapy in patients with chronic hepatitis C. Comparison between non-drinkers and drinkers.  Scand J Gastroenterol. 1994;  29 1039-1043
    Google Scholar
  • 31 Okuda K, Ohnishi K. The role of viral infections in alcoholic liver disease. In: edited by P. Hall: Alcoholic Liver Disease Edward Arnold, London, Boston, Melbourne, Auckland 1995: 147-159
    Google Scholar
  • 32 Oshita M, Hayashi N, Kasahara A. et al . Increased serum hepatitis C virus RNA levels among alcoholic patients with chronic hepatitis C.  Hepatology. 1994;  20 1115-1120
    Google Scholar
  • 33 Pares A, Barrera J M, Caballeria J. et al . Hepatitis C virus antibodies in chronic alcoholic patients: association with severity of liver injury.  Hepatology. 1990;  12 1295-1299
    Google Scholar
  • 34 Pessione F, Degos F, Marcellin P. et al . Effect of alcohol consumption on serum hepatitis C virus RNA and histological lesions in chronic hepatitis C.  Hepatology. 1998;  27 1717-1722
    Google Scholar
  • 35 Poynard T, Bedossa P, Opolon P. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups . Natural history of liver fibrosis progression in patients with chronic hepatitis C.  Lancet. 1997;  349 825-832
    Google Scholar
  • 36 Rosman A S, Waraich A, Galvin K, Casiano J, Paronetto F, Lieber C S. Alcoholism is associated with hepatitis C but not hepatitis B in an urban population.  Am J Gastroenterol. 1996;  91 498-505
    Google Scholar
  • 37 Sawada M, Takada A, Takase S, Takada N. Effects of alcohol on the replication of hepatitis C virus.  Alcohol Alcohol. 1993;  85-90 (Suppl 1B)
    Google Scholar
  • 38 Serfaty L, Chazouilleres O, Poujol-Robert A. et al . Risk factors for cirrhosis in patients with chronic hepatitis C virus infection: Results of a case-control study.  Hepatology. 1997;  26 776-779
    Google Scholar
  • 39 Sherman K E, Mendenhall C, Thee D L, OBrien J, Rouster S D. Hepatitis C serotypes in nonalcoholic and alcoholic patients.  Dig Dis Sci. 1997;  42 2285-2291
    Google Scholar
  • 40 Shev S, Dhillon A P, Lindh M. et al . The importance of cofactors in the histologic progression of minimal and mild chronic hepatitis C.  Liver. 1997;  17 215-223
    Google Scholar
  • 41 Silini E, Bottelli R, Asti M. et al . Hepatitis C virus genotypes and risk of hepatocellular carcinoma in cirrhosis: A case-control study.  Gastroenterology. 1996;  111 199-205
    Google Scholar
  • 42 Spinozzi F, Agea E, Bassotti G. et al . Ethanol-specific impairment of T-lymphocyte activation is caused by a transitory block in signal-transduction pathways.  Gastroenterology. 1993;  105 1490-1501
    Google Scholar
  • 43 Suzuki M, Suzuki H, Mizuno H. et al . Studies on the incidence of hepatocellular carcinoma in heavy drinkers with liver cirrhosis.  Alcohol Alcohol. 1993;  109-114 (Suppl 1B)
    Google Scholar
  • 44 Takada A, Takase S, Tsutsumi M. Characteristic features of alcoholic liver disease in Japan: A review.  Gastroenterol Jpn. 1993;  28 137-148
    Google Scholar
  • 45 Verbaan H, Andersson K, Eriksson S. Intravenous drug abuse - the major route of hepatitis C virus transmission among alcohol-dependent individuals?.  Scand J Gastroenterol. 1993;  28 714-718
    Google Scholar
  • 46 Wiley T E, McCarthy M, Breidi L, Layden T J. Impact of alcohol on the histological and clinical progression of hepatitis C infection.  Hepatology. 1998;  28 805-809
    Google Scholar
  • 47 Yamauchi M, Nakahara M, Maezawa Y. et al . Prevalence of hepatocellular carcinoma in patients with alcoholic cirrhosis and prior exposure to hepatitis C.  Am J Gastroenterol. 1993;  88 39-43
    Google Scholar
  • 48 Zaaijer H L, Cuypers H T, Reesink H W, Winkel I N, Gerken G, Lelie P N. Reliability of polymerase chain reaction for detection of hepatitis C virus.  Lancet. 1993;  341 722-724
    Google Scholar
  • 49 Zarski J P, Thelu M A, Moulin C, Rachail M, Seigneurin J M. Interest of the detection of hepatitis C virus RNA in patients with alcoholic liver disease. Comparison with the HBV status.  J Hepatol. 1993;  17 10-14
    Google Scholar

Korrespondenz

Dr. med. D. M. Alscher

Abteilung Innere Medizin IVZentrum für Innere MedizinRobert-Bosch-Krankenhaus

Auerbachstraße 110

70376 Stuttgart

Phone: 0711/81013496

Fax: 0711/81013792

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